Authored by Ericka Valenzuela, DO, Primary Care Physician with Garnet Health Doctors

It’s the time of year when children and their parents visit the offices of Garnet Health Doctors for back-to-school physicals. During these well-visits, we cover a variety of topics to ensure a child can begin the school year healthy and ready to learn. From vaccinations to pre-existing conditions; preparedness and prevention, our interactions with families during back-to-school season establish an important set of parameters that help ensure a student’s health throughout the school year.


The most common item is whether or not a student’s required vaccinations are up to date. While the majority of children receive their vaccines according to the guidelines outlined by the Centers for Disease Control and Prevention, some parents do inquire about taking a slower course of vaccinations than recommended and others want to know if all vaccinations are necessary..

It is preferable that everyone is up to date on their required vaccinations in order to avoid community outbreaks of diseases, so we have candid conversations with parents, to make sure they understand the risks involved with not vaccinating their child. I also remind parents to communicate  their choices regarding vaccinations with the school. Illnesses people need to stay particularly vigilant of when it comes to non-vaccinated children are:

  • Chicken pox
  • Mumps and measles
  • Pertussis

The latter two of which have actually broken out in our communities over the past couple of years.

Pre-existing Conditions

Discussing pre-existing conditions – is very important, as is making sure that any related prescriptions are filled and not expired. The most common pre-existing condition is asthma, which can be exercise induced, allergy induced or exacerbated by a viral illness. We make sure the child has easily accessible inhalers for both home and school, if prescribed.

Allergies are also common. We pay particular attention to those that can lead to anaphylaxis, a potentially life-threatening reaction that can proceed rapidly within moments of exposure to an allergen. Peanuts and bee stings are common culprits. In these instances, we make sure the student has an injectable dose of epinephrine, commonly known as an “epi pen,” available to them at all times at school and at home.

Common & Catchable

It’s a cringe-worthy topic, but schools and classrooms really are the perfect breeding ground for the germs that cause illnesses. The close quarters make contact with one another all but unavoidable, and shared germs a foregone conclusion. With students getting back into the school year, we make sure to discuss common illnesses and preventive measures.

Common colds, the flu and strep throat are three very common illnesses that seem to spread in September and into the cooler months of fall and early winter. Pink eye, known as either bacterial or viral conjunctivitis, is a highly contagious illness that presents with redness of the eye and surrounding pink skin, along with yellowish discharge.

Fifth Disease is another viral illness. Caused by the parvo virus, it is another illness that presents with cold-like symptoms of fever and runny nose. Within a few days, though, the patient will develop a rash on the face that looks like a slapped cheek. Although it is very contagious, medication is usually not indicated, as it is self-limiting with proper supportive care.

In younger students, under five- years- old, Hand, Foot and Mouth Disease is quite common. It presents with fever, a rash of the hands and feet, along with blisters in the mouth. It is caused by the Coxsackievirus and is very contagious, but also very self-limiting when treated properly.

Finally, we do see some respiratory illnesses and skin diseases that are typical in children. Ringworm is a fungal skin infection, sometimes specifically noted on the scalp. Impetigo is a bacterial infection which affects the superficial layers of the skin. Not as common, but still an issue in the close environs of a school setting are scabies and lice. Children are usually vaccinated against Whooping Cough, but it did pop up in our area last year. Symptoms begin with a cough or runny nose for a week or two, and develop into persistent coughing spells that can even lead to throwing up and respiratory distress for very young patients.

Preaching Prevention

The best defense against all of these illnesses is vigilance and prevention. I always drive home the basics of personal prevention when I talk to children and their parents.

  • Frequent hand washing or using hand sanitizer is important.
  • If you have a cough or sneeze, doing so into a Kleenex or the crook of your elbow is the best way to contain it.
  • Children should be told to avoid sharing school supplies or snacks with sick classmates.
  • And, even though it can create difficult issues of planning and childcare, keeping your sick student home from school is the most responsible defense against the transmission of germs.

My colleagues and I at Garnet Health Doctors are here for your back-to-school needs. Not only can we help identify and manage those common September sniffles and other symptoms your student may develop, but we can help you when they bring them home, too.

It is also important to note that every time one of us fills out the required school physical form, we always make sure to include our name and office contact information so that the lines of communication are open between our office and the office of your child’s school nurse. Of course, parents and school nurses are always encouraged to call us at 845-333-7575 if there are any questions or concerns, from symptoms to medications.

About Dr. Ericka Valenzuela
Dr. Valenzuela, a Board-certified Family Medicine physician, treats the whole family, including newborns, toddlers, school aged children/teenagers and adults. Dr. Valenzuela received her medical degree from Kansas City University of Medicine and Biosciences in Kansas City, MO and finished her Residency in North Carolina at one of the University of North Carolina residency programs in Family practice in 2007. She has been practicing medicine for 11 years and likes educating her patients on preventing disease.

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